Since the application of laparoscopic surgery in gastrointestinal surgery, many open surgeries have been attempted laparoscopically, and the scope of its application is rapidly expanding, with a considerable number of procedures having demonstrated their unique advantages. Now on the laparoscopic surgery in gastrointestinal disease surgery in the application of an overview. First, laparoscopic gastric surgery 1, laparoscopic surgery for ulcer disease: although not routinely used, but the status of laparoscopic technology for ulcer perforation repair has been established. Many open surgeries such as: gastroduodenal ulcer perforation repair, vagotomy and gastric resection can be completed laparoscopically. Laparoscopic ulcer perforation repair is similar to the open surgical method, and its outstanding advantages are that it can clarify the diagnosis, easy operation, good results, and peritonitis can be controlled soon after perforation repair and adequate irrigation of the abdominal cavity [1]. The perforation can be sutured directly under the microscope, or can be plugged with fibrin glue, or covered and filled with large omental tissue [2]. Laparoscopic completion of major gastric resection and reconstruction first appeared in 1992, and is mainly used for scarring pyloric obstruction caused by ulcers as well as for the treatment of huge, refractory and suspected malignant gastric ulcers, and also for the resection of larger benign tumors of the stomach. Lu Yiping, Department of Surgical Oncology, Beijing Hospital of Traditional Chinese Medicine, Beijing, China 2, laparoscopic surgery for the treatment of obesity: in the late 1980s, laparoscopy began to be introduced into bariatric surgery and achieved rapid development, and now commonly used bariatric surgery can be performed laparoscopically [3].Lee et al. [4] showed that laparoscopic bariatric surgery and open surgery, compared with the minimally invasive effect of the outstanding, at the same time, the gastro-esophageal area is well exposed, postoperative cosmetic effects, and can avoid incisional hernia. good, and can avoid complications such as incisional hernia and intestinal adhesion. However, it requires certain equipments and high operation techniques, the operation time is slightly longer than that of open surgery, and the cost is higher. Laparoscopic gastric Roux-en-Y bypass (LRGB), laparoscopic vertical banded gastroplasty (LVBG) and laparoscopic adjustable banded gastric reduction ( 1aparoscopic adjustable gastric banding (LAGB) are the three most commonly used procedures for the treatment of morbid obesity. It has been proved that among these three procedures, LRGB has the best long-term weight reduction effect on the treatment of patients with severe obesity, and its disadvantage is that the surgery is more complicated, with higher perioperative complications and a certain degree of surgical mortality, and LRGB is generally used for the treatment of super-obesity at present. Long-term follow-up of patients with LVBG has proved that because patients tend to change their dietary habits to high-sweet, high-calorie fluids, there is a significant increase in postoperative weight gain in the long term.The minimally invasive nature of the LAGB is an extremely prominent advantage, because it does not change the normal anatomy of the gastrointestinal tract, the surgical operation is relatively simple, and the incidence of perioperative complications is much lower than that of other surgical procedures, therefore, it has become a hot spot of the research in recent years [5]. Laparoscopic surgery for reflux disease: For gastroesophageal reflux disease (GERD), although proton pump inhibitors are very effective in reducing the symptoms of reflux, the recurrence rate is as high as 80% after stopping the drugs. Nissen first reported the procedure in 1956 and Dallemagne first described the laparoscopic Nissen fundoplication in 1991. Laparoscopic Nissen fundoplication has become the standard surgical procedure for the treatment of GERD, which in the short term greatly improves the symptoms of esophageal reflux thereby improving the quality of life of the patients and increasing their cure rate to more than 90% [6,7]. The most common and important postoperative complication is dysphagia, which has been reported to occur as high as 100% in the early stage and 2% to 31% in the long term, making it very difficult to manage and requiring sufficient experience on the part of the operator. 4, Laparoscopic surgery for gastric endoluminal diseases: Bhoyrul et al. were the first to carry out a study of the environment and advantages of laparoscopic surgery applied to the cavity organs. Endoluminal Surgery represents another possible area of entry for minimally invasive surgery. This technique requires the use of a special puncture trocar, the Radially Expanding Device (RED), which allows laparoscopic access to almost all parts of the gastrointestinal tract. The most performed procedures are gastric anastomosis and resection of gastric smooth muscle tumors for pancreatic pseudocysts, resection of gastric mucosal tumors, and treatment of bleeding ulcer disease [8,9]. After passing through the anterior abdominal wall to enter the abdominal cavity, the rigid puncture trocar used for endoluminal surgery must also pass through the anterior wall of the stomach to enter the gastric cavity, and this situation restricts endoluminal surgery to treating only lesions in or near the posterior wall of the stomach. 5. Laparoscopic surgery for gastric cancer: Due to rich blood supply, multiple anatomical layers and complex anastomosis, gastric cancer surgery requires high surgical techniques, so the development of laparoscopic surgery for gastric malignant tumors is slow. For early gastric cancer that only invades the mucosal layer and has no lymph node metastasis, laparoscopic gastric partial resection can be used, such as laparoscopic wedge resection (LWR) and intragastric mucosal resection (IGMR). Laparoscopic radical gastric cancer surgery can be categorized into three types: complete laparoscopic, laparoscopic-assisted, and hand-assisted laparoscopic radical gastric cancer surgery. According to the site of the tumor, laparoscopic radical gastrectomy for gastric cancer can be further divided into laparoscopic major distal gastrectomy (LADG), laparoscopic major proximal gastrectomy (LAPG), and laparoscopic total gastrectomy (LATG). Currently LADG is the most commonly used surgical procedure. For radical resection of tumors, the most discussed issues are the number of gastric margins and lymph node dissection. Many clinical studies have shown that laparoscopic D2 lymph node dissection for progressive gastric cancer is feasible and safe, and can achieve the same radical results as open surgery. Regarding the evaluation of the advantages of laparoscopic radical gastric cancer surgery, many scholars compared the operation time, bleeding, complication rate, mortality rate, postoperative gastrointestinal function recovery time, postoperative hospitalization time and other elements of laparoscopic surgery and similar open surgery. It is believed that laparoscopic radical gastric cancer surgery has less bleeding, less postoperative pain, faster recovery of postoperative gastrointestinal function, and shorter postoperative hospitalization time, which fully reflects the minimally invasive advantages of laparoscopy [10]. Second, laparoscopic small bowel surgery 1, laparoscopic small bowel adhesion release: postoperative intestinal obstruction is a common postoperative complication, 49%~74% of small bowel obstruction is caused by intra-abdominal adhesions [11]. Laparoscopic surgery can completely release abdominal adhesions, and has the advantages of less trauma, less gastrointestinal interference, abdominal wall incision away from the original abdominal adhesions, getting out of bed early, early recovery of gastrointestinal function, etc., and the chances of re-formation of adhesions after the surgery are significantly reduced than that of open surgery [12]. The most common complication is an undetected enterocutaneous fistula during intestinal adhesion release. There is a possibility that the plasma membrane may be dissected during the release of intestinal adhesions, which requires repair. In many cases of laparoscopic small bowel adhesion release, the author found that severe adhesions caused by pathologic intestinal collaterals, it is estimated that postoperative adhesions will be formed again or intestinal contents through the obvious obstacles, should be decisively resected, or may be re-obstructed after the operation and have to undergo a second operation. 2, laparoscopic small bowel resection: laparoscopic small bowel resection can be used for a variety of small bowel diseases, microscopy can be found in the small bowel stenosis or mesenteric vascular injury and other lesions, it is also easy to find the small bowel benign and malignant tumors. The most difficult to determine the intestinal lumen smooth muscle tumor or polyp-like lesions, laparoscopic surgery before endoscopic activated charcoal injection is conducive to intraoperative identification. When small bowel resection is required for upper gastrointestinal bleeding, dye can be injected at a site determined by angiography to determine the extent of bowel resection based on the area of small bowel plasma membrane staining. For those with multiple negative preoperative tests and high clinical suspicion of small bowel pathology, laparoscopic exploration can both clarify the diagnosis and administer curative treatment. There are two types of surgery: total laparoscopy and laparoscopic-assisted small bowel resection. Laparoscopic-assisted small bowel resection is more practical, easy to operate, and after the lesion is resected, intestinal anastomosis is performed in vitro. Because the specimen after total laparoscopic small bowel resection is often to be removed by expanding the incision to 3 cm, and this opening is sufficient for laparoscopic-assisted small bowel resection. Third, laparoscopic appendectomy In 1983, German doctor Semn reported the world’s first laparoscopic appendectomy, the first laparoscopic cholecystectomy 4 years earlier. Laparoscopic appendectomy surgical indications and open appendectomy, appendiceal perforation or abscess is not a contraindication to surgery, and laparoscopic exploration significantly improves the accuracy of surgical diagnosis. Compared with open surgery, the operation time is slightly prolonged. Specimens from laparoscopic appendectomy are removed through a specimen bag, resulting in a significant decrease in incisional infection rates. However, there is a relative increase in the expenditure on instrumentation.Ball et al [13] showed that for complex appendectomies, laparoscopic surgery is safer and more effective than open surgery. Fourth, laparoscopic colorectal surgery The anatomical characteristics of the colorectum make it suitable for laparoscopic surgery. The first laparoscopic colorectal surgery was completed in 1990. With the improvement of surgical techniques and instruments and equipment, the indications for surgery and the scope of surgery are still expanding. 1, Laparoscopic surgery for benign colorectal diseases: laparoscopic surgery has become an ideal method for experienced surgeons to treat benign colorectal diseases [14]. Commonly used procedures include: (1) Laparoscopic colonic diverticulectomy: the diverticulum is cut off from the root with ENDO-GIA and repaired if necessary. (2) Laparoscopic partial colectomy: for the resection of benign tumors of the colon, such as adenomas and smooth muscle tumors that cannot be removed by colonoscopy. (3) Laparoscopic total colectomy: for lesions involving the whole colon, such as multiple polyps, segmental colitis, etc., surgical difficulty, less application at present. (4) Laparoscopic rectal fixation: used in the treatment of rectal prolapse, laparoscopy can provide a clear vision for separating the presacral space and the anterior rectum and reduce collateral damage. The polypropylene mesh can be fixed to the sacrum with titanium staples, or the mesh can be sutured to the sacrum with microscopic suturing technique. 2.Laparoscopic surgery for colorectal cancer: Laparoscopic surgery for colorectal cancer is now widely carried out all over the world, and a large number of clinical researches have demonstrated the clinical efficacy and minimally invasive superiority of laparoscopic radical surgery for colorectal cancer and laparoscopic radical surgery for rectal cancer. There is no significant difference between surgical complications and open surgery, and the operation time and intraoperative bleeding are better than those in the open group. Total mesorectal excision for intermediate and low rectal cancer has more advantages in laparoscopic operation: more accurate judgment of the loose tissue gap between the two layers of the pelvic fascia and the dirty wall, more accurate protection of the pelvic nerve plexus due to the magnifying effect of laparoscopy on the local field of vision, more complete resection of the rectal mesentery by sharp dissection along the pelvic fascial gap by ultrasonic knife, and more complete resection of the rectal mesentery through the monitor and record of the surgical process through the screen and strict control of the oncological surgical standard. Numerous clinical studies have reported that the length of bowel resection for laparoscopic colorectal cancer resection is adequate. There was no difference in the number of lymph nodes cleared compared with comparable open procedures. Metastasis of cancer perforation holes is not unique to laparoscopy but is related to improper operating technique. A recent clinical report on a prospective randomized controlled study of laparoscopic colorectal cancer surgery showed no difference in 3- and 5-year survival rates between laparoscopic colorectal cancer surgery and comparable open surgery [15].